Public Health Midterm

Core Values of Public Health Law

prevention
social justice
government

Goals of public health law

Ensure the conditions for people to be healthy
Pursue the highest possible level of physical and mental health in the population, consistent with the values of social justice

Legal tool used to promote health

Direct regulation
Indirect regulation through the tort system
Alteration of socioeconomic, built, and physical
Deregulation
Taxation and Spending

Major reasons behind the enormous gains in health

Sanitary movement
Plentiful food and leisure

Resource for everyday life, not the objective of living

Ottawa Charter for Health Promotion

Capacity for living a full and productive life

Positive health dimension

State of complete physical, mental and social well-being and not merely the absence of disease or infirmity

WHO def

Public Health Waves

Infectious disease control, extending the quality of life, chronic disease control

3 core functions of governmental public health

Assessment (public health surveillance to measure health of the population)
Policy Development (exactly how it sounds)
Assurance (assure health of population by having a competent workforce to enforce laws)

10 Essential Public Services

1.Monitor health status to identify and solve community health problems;
2.Diagnose and investigate health problems and health hazards in the community;
3.Inform, educate, and empower people about health issues;
4.Mobilize community partnerships to identi

State Public Health Labs

Network consisting of all the participants in PHL testing, including those who initiate testing and those who ultimately use the test results

Local Public Health Labs

Exist solely with the incentive, mission, and community ownership to address laboratory services for local public health and safety
Role of local PHL in supporting local public health dept. varies by the size of the community served, the relationship with

Values of a public health lab

Lab testing affects clinical decisions and provides info that aids in the prevention, diagnosis, treatment, and management of disease
Provides objective data about patient health
Hospital acquire outbreak investigations
Detecting unusual antimicrobial res

11 Core functions of Public Health

Disease prevention, control, and surveillance
Integrated data management
Reference and specialized testing
Environmental health and protection
Food safety
Laboratory improvement and regulation
Policy development
Emergency response
Public health-related re

Strategies to prevent

Antiretroviral therapy
Pre-exposure prophylaxis with daily oral tenofovir or tenofovir plus emtricitabine eff actively reduced HIV acquisition in four of six trials
Vaginal and, more recently, rectal microbicides are attractive interventions because, unli

What are the big challenges that face the development of an effective HIV vaccine?

Genetic diversity of HIV
Uncertainty about what constitutes protective immunity
Difficulty in the development an antigens that are highly immunogenic

What are the discoveries and implemented prevention strategies that helped declining the overall stage 3 (AIDS) classifications and deaths of persons with stage 3 (AIDS)?

Breakthroughs in early detection of HIV infection, improved screening technologies, advances in antiretroviral and combination drug therapies, prophylactic medications against opportunistic infections, and HIV prevention awareness campaigns
However, the p

Major biomedical evidence-based HIV prevention approaches

PrEP: The ongoing use of one or two antiretroviral medications by HIV negative individuals to prevent HIV infection
Treatment as Prevention (TasP): Evidence has shown that HIV+ persons who are on antiretroviral treatment (ART) with suppressed viral loads

ACA increasing scope of prevention

Expanded coverage access
No-cost preventative services (clinical, cessation)
Public health investments

Actions needed to reduce tobacco smoking

Enhanced surveillance to better characterize the toll of COPD
Improved systems of care to increase early detection
Improved coordination
Community based intervention focus
Research investment

Key provisions of the ACA

3205 requires CMS to reduce payments to inpatient prospective payment plans
CMS expanded applicable conditions to include patients admitted for acute exacerbation of COPD
Non-profit patient centered research (identify clinically effective treatments)
INSU

Tobacco Control Prevention Program Priority Areas

Reduce youth access to ALL tobacco products
Reduce exposure to second hand smoke
Increase access to cessation services
Media/public education campaigns

Infection

infectious agent enters a body and develops or multiplies

Infectious agents

organisms capable of producing inapparent infection or clinically manifest disease and include bacteria, parasites, and viruses.

Infectious disease

infection that results in a clinically manifest disease, may also be due to the toxic product of an infectious agent

Control of Infectious Disease

Disease actions and programs directed toward reducing disease incidence, reducing disease prevalence, or completely eradicating the disease

Pathogenicity

extent to which clinically manifest disease is produced in an infected population
ability of an organism to cause disease

Virulence

the extent to which severe disease is produced in a population with clinically manifest disease
degree of pathology caused by the organism (ability of a pathogen to multiply)

Route of Transmission

The mechanisms by which infectious agents are spread from reservoirs or sources to human hosts

Source

the person, other living organism or inanimate material from which the infectious agent came

Reservoir

Any person, other living organism, or inanimate material in which the infectious agent normally lives and grows

Horizontal Infection

Horizontal Infection: transmission

Vertical Transmission

mother to offspring

Infectious Dose

amount of pathogen (measured in number of micro-organisms) required to cause an infection in the host

Primary Prevention

Control aimed at reducing the incidence of disease
legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
education about healthy and sa

Secondary Prevention

Control aimed at reducing the prevalence by shortening the duration of infectious disease (disease already occurred)
Regular exams and screening tests

Tertiary Prevention

Control aimed at reducing or even eliminating long-term impairments of infectious disease
cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)
support groups that allow members to

Direct Transmission

Direct and essentially immediate transfer of infectious agents to a receptive portal of entry through which human or animal infection may take place. This may be by direct contact as touching, biting, kissing or sexual intercourse, or by the direct projec

Indirect Transmission

Contaminated inanimate objects or objects

Indirect Vector Borne Mechanical

Crawling or flying insect through the soiling of its feet, doesn't require multiplication

Indirect vector borne biological

Propagation, cyclic development or combination required before transmission

6 elements of chronic care management model for a fuller continuum of SUD

Withdrawal management,
recovery support services,
outpatient,
intensive outpatient,
short-term residential,
opioid treatment programs

Measures used to determine whether the quality of data is appropriate for surveillance purposes

� Timeliness
� Accuracy
� Completeness
� Representativeness

The objective of public health is to guarantee the health of all, regardless of ethnicity, religion, gender, sexual orientation, country, or political views

False
Ensure the conditions to be healthy

Life expectancy is increasing in

Developing and developed countries

Increasing health literacy can be considered as one of the outcomes of health protection

False

Diet and exercise are not

Biomedical interventions

Transtheoretical Model of Change

Describes five stages individuals progress through when attempting to change a health behavior

Structural interventions include

increasing tobacco taxes
Mandating a helmet law

Interventions can be applied to promote smoking cessation

Behavorial
Structural

Non-communicable diseases (NCDs) are the following medical conditions or diseases, EXCEPT

Mainly diarrheal diseases, tuberculosis, and malaria

Four major NCDs in the world include the following, EXCEPT

HYPERTENSION

Four leading risk factors for non-communicable disease deaths

High blood pressure, high blood sugar, tobacco use, physical inactivity

The four major preventable risk factors for NCDs defined by WHO are the following,
EXCEPT

Genetic susceptibility

Bump in cancer incidence

PSA screening test

Leading cause of death worldwide

cardiovascular diseases

Highest crude cancer rate

high income (cardio death rate higher in low income countries)

Epedimology is

A methodology
Core strategy of public health

One of the two main concepts of epidemiology is

agent, host, environment (time person place)

Which of the following metrics should be used to measure the spread of an epidemic?

Incidence

Point incidence

Population at risk at a single point in time

The diagnostic criteria for a disease in a surveillance system should be

Functional to use
Reasonably accurate

Population boom

1950-2000 (only region whose share of global population didn't decline was africa)

Regular health examinations and early detection of work-related health problems are examples of

Secondary prevention

Putting a "funnel lock" to prevent burns from multiple coffee makers is an example of

primary prevention

Farming food organically is an example of

primary prevention

Which region of the US has the highest prevalence of obesity (BMI>29)?

The south

Disability adjusted life years due to mental illness are second only to cancer in frequency in the United States

False

Key elements of surveillance include:
a. Timely analysis
b. Dissemination of results
c. Action based on results
d. Accurate diagnosis
e. a., b., and c. above

a,b, and c

Use(s) of surveillance include(s):
a. Monitoring changes in prevalence
b. Monitoring changes in incidence
c. Documenting past clinical disease
d. All of the above
e. a. and b. above

a and b

The most commonly used study design for conducting surveillance is: a. Cohort
b. Cross-sectional survey
c. Serial cross-sectional surveys
d. Ecologic
e. Nested case-control

serial-cross sectional surveys

The U.S. Morbidity and Mortality Weekly Report uses which kind of surveillance?
a. Anecdotal
b. Passive
c. Active
d. Voluntary

Passive

Sentinel surveillance can be used for advocacy to stimulate action

True

The following characteristics should be evaluated in assessing quality of surveillance:
a. Sensitivity
b. Flexibility
c. Clinically accurate diagnosis
d. All of the above
e. a. and b. above

a and b

The "predictive value positive" is:
a. The proportion of persons testing positive who truly have the disease
b. The proportion of persons with the disease who were tested
c. The proportion of persons with the factor who test positive
d. The proportion of

a

To assess the extent of the current epidemic of HIV/AIDS surveillance systems should identify:
a. Persons with current clinical AIDS
b. Persons with current HIV infection
c. Persons previously infected with HIV
d. Recovered AIDS cases

b

Very detailed figures and graphs should be used to stimulate action by decision makers:
a. True b. False

false